| NPI | 1396403051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONIHUE WATERS Co Owner 912-660-3706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |